What To Expect: Intern Year

By Amy Rakowczyk, SDN Staff Writer

You’ve likely heard the rumors about the dreaded Intern Year. It’s the worst of the worst. Say goodbye to your partner and hello to lonely days and nights. But are the rumors really true? And if they are, what can you do about it?

I remember when my husband was a few months into MS3, and we were feeling the med school blues. Third year was particularly challenging for my family, so I already felt like my life and relationship were struggling. One day, I happened to attend a “Baby and Me” yoga class with my nine-month old, and the mom sitting next to me started a conversation by asking me what my husband did. I replied “he’s in medical school,” and she just laughed and shook her head. She replied, “My husband is an intern. I wish someone had told me how horrible it was going to be. If you think it’s bad now, just wait. It gets so much worse.”

My heart sank. I almost started crying right then and there. I already felt close to the bottom, how could we endure “much worse?” What does that even look like? It terrified and haunted me for the rest of med school. I know she was trying to be helpful, and she was just experiencing her own rough patch, but at the time I just couldn’t imagine things getting any harder for my family. We knew something had to change going into residency.

My husband is now PGY-2, and I’m happy to report that we not only survived intern year, but we’re thriving in residency—so much more than we were in medical school. All this PLUS we added another child to our family! (Curious about having kids in med school? Go HERE.)

So, are you fated for a 3-5+ year journey of solitude and sadness, questioning why you’ve agreed to all this? Every residency program and speciality is different, so it’s best to ask other residents in the program for the specifics regarding schedule and demands. However, the emotional challenges are similar across the board.

I’m going to tell you how we, and many of my fellow medical spouses, have survived that first year of residency. I’m going to be very real and give you the honest truth.

Sometimes it’s really hard. You’ll know the depth of the meaning of the word “hard” when you’re living it. BUT, it’s not a 24/7, 365-day deal. It comes in cycles. Please remember that! It won’t always “be like this.” You’ll dwell in the pit for a couple weeks, then come up for some air and prep for another dive. Those moments on the surface are blissful and feel, dare I say, “normal.” It’s not all bad.

What it is, is challenging. You and your partner will be challenged in your abilities to care and love for each other and family while being under a lot of pressure and largely self-sufficient. You’ll be challenged to forgive, to give selflessly, and to be kind under incredibly hard circumstances. You both will have to learn how to communicate with each other in the smallest fractions of time, and learn to treasure those weekends off and short work days so they are enjoyable, and not spent arguing or hurting each other.

This probably sounds like too much, and a little “suck-it-up-and-deal-with-it,” but let me reassure you, you will be able to do this, and your needs and feelings are just as important as your partners. Through a lot of honest and real conversation—and some compromise—you can find a workable arrangement for these residency years.

Adopt this motto: Hope for the best, but prepare for the worst. Put on your rose-colored glasses, look for and focus on the good, but be real when you need support. I’m not saying to “put on a front” and pretend everything’s okay. That will lead you right into an abyss. Agree on some communication terms with your spouse and get help if needed. Take care of yourself and find some friends who you can be a bit vulnerable with, who you can turn to when you feel your knees buckling.

If you haven’t read my previous articles, intern year is a good time to visit some of the following links. They are like step-by-step guides to improve your communication with your spouse, set up some support for yourself, and prepare you mentally for the day-to-day life of medical training.

“Defining Your Expectations”
“Not Ours Anymore”
“Sharing Household Duties”
“Building a community” and finding other “Medwives”
“5 Things You Can Do To Connect With Your Medical Spouse”

I promise you that if you go through these articles and have even a few of these discussions with your partner, you’ll be in a much better place to take on intern year and the rest of training.

Additionally, in my experience being a military spouse and now a doctor’s spouse, there’s one question that has shifted my perspective and opened up many more possibilities for happiness during medical training. It’s this:

If you were trying your very best to meet all of your obligations, and you felt stressed all day, being stretched mentally, emotionally, and physically, what kind of home and partner would you want to come home to?

Be honest about this. I think most of us would want to come home to a warm embrace, with someone telling you “All is well, my love. I’m so proud of you and all your hard work. Thank you for everything you do.” This is your secret tool that will help you, your partner, and your relationship make it out of this stage with much fewer bruises to the heart.

Yes, maybe you’re feeling hurt or you’re mad at them. Maybe they haven’t been there for you, or been there to help with anything household or family related. Maybe they’re exhausted, checked out, moody and cranky, and you get to be the one to deal with them.

Even so, try to start from a place of love. Focus on the bond of love between you and your partner as the most important thing, instead of focusing on the hurt or anger. Certainly the hurt and anger need to be addressed, but by letting your anger build all day, blaming your partner, and then lashing out or withdrawing when you finally see them, that will only cause more hurt and push them away. Anger and hurts comes and go, but your love for each is constant. It’s your foundation.

Remember, too, that taking care of yourself is the most powerful way to help support your spouse. You must make yourself a priority and find activities and people that build you up, feed your soul, and empower you. Knowing that you are taken care of, emotionally and psychologically, will be one less thing your spouse will have to worry about during their busy and trying days. It’s really the best gift you can give them during this time. Yes, you still need them and want them a part of your everyday. You will get that time with them, but it’s not always everyday, or the exact moment you need it. That’s why you have to have other healthy options in place.

In conclusion, you can adopt sort of a 3-step plan to not only “get through” intern year, but find some enjoyment in it as well:

  1. Adopt the motto: Hope for the best, prepare for the worst.
  2. Ask yourself the question: what kind of home and partner do you want to come to? Be that for your partner, even when there are hurt feelings or challenges to be addressed. Start with love.
  3. Take care of yourself. It’s the best gift you can give to yourself, your spouse, and your family.

As I’ve said before, you can do this! You are capable and can do hard things. You also have a tribe of medical spouses here with you, going through exactly what you’re going through. Reach out!

About the Author
Amy Rakowczyk is a medical spouse, mother, writer, singer, and former voice instructor. She currently resides in Galveston, TX with her husband and two young daughters. She enjoys helping other spouses navigate the world of medicine and actively participates in support groups and activities. Her husband is a Family Medicine resident at UTMB Galveston and did his medical training at The Ohio State University. 

2 Replies to “What To Expect: Intern Year”

  1. What a wonderful article! I’m hoping to be in med school in a couple years. My husband and I have a really nice work/life balance now, so I’ve been anticipating how it will change when I’m in school. Thanks for the solid advice! Great advice for any married couple, really 🙂

  2. Thanks for great article, Amy. Being a good doctor is truly where life and medicine have found the perfect balance. I hope everyone too will give the MD profession consideration as he goes about life and pursue a rewarding career in the field of medicine.

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